Healthcare Provider Details

I. General information

NPI: 1659177335
Provider Name (Legal Business Name): VISTA DERMATOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2025
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1058 OLD DES PERES RD
SAINT LOUIS MO
63131-1865
US

IV. Provider business mailing address

1058 OLD DES PERES RD
SAINT LOUIS MO
63131-1865
US

V. Phone/Fax

Practice location:
  • Phone: 415-802-1310
  • Fax:
Mailing address:
  • Phone: 314-266-0412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TRISHA BHAT SCHARFF
Title or Position: OWNER
Credential: MD
Phone: 314-266-0412